If the DWB claimant is engaging in SGA, consider entitlement to a closed period of disability. If there is not a 12-month period of non-SGA immediately preceding the current SGA, follow existing procedures to deny the claim. The month the claimant began SGA must be within 14 months prior to the month of application.

Take the following actions:

Document the work activity on the SSA-821-BK (Work Activity Report-Employee) or the SSA-820-BK (Work Activity Report-Self Employment) and your determination on the SSA-823-U3 (Report of SGA Determination). Store the SSA-820-BK, SSA-821-BK, and SSA-823-U3 documents in the certified electronic folder (CEF).

The disability determination services (DDS) may inadvertently prepare a favorable determination for a DWB claim for which the prescribed period requirement expired before the established onset date (EOD).

The field office (FO) returns these cases to the DDS to investigate the possibility of an earlier onset date. The DDS prepares a new determination and records it on a new SSA-831-U3.

Process the allowance or denial accordingly and release the appropriate notice.

When the claimant does not present new facts in a subsequent claim, deny DWB claims filed after a prior determination or decision that the claimant was not disabled on or before the last day of the prescribed period on the basis of res judicata.

For complete instructions on the applicability of res judicata, see Field Office (FO) Res Judicata Development and Processing DI 27516.001.

Send potential DWB res judicata denials to the DDS for a medical review if they do not meet the conditions for FO jurisdiction discussed in Res Judicata Development and Processing DI 27516.001-.

If the DDS determines that res judicata applies, the DDS notifies the FO by annotating the CEF at case closure with the message: “Res Judicata applicable to claim filed on (date of subsequent application).”

The prescribed period for Medicare purposes extends to age 65 for DWB cases.

Deny the DWB-Medicare claim if:

at the POD the claimant is age 62 and 7 months and he or she was never previously entitled to any disability (Disabled Individual Benefits (DIB), Childhood Disability Benefits (CDB), or Disabled Widows Benefits (DWB)) or SSI benefits.

For claimants with prior entitlement to SSI or federally administered State Supplementary Payments you may credit SSI/State Supplementary Payments (SSP) eligibility months to the qualifying period for Medicare entitlement, see DI 11015.020. or

the POD is within the prescribed period, but the claimant’s death occurs prior to adjudication and before expiration of the 24-month qualifying period for entitlement to Medicare.